[Success and failure of the ventriculoperitoneal shunt in the treatment of hydrocephalus].

In ventriculoperitoneal shunting, the intraperitoneal location of the drainage site can be an additional cause of failure. In our series of 70 ventriculoperitoneal shunts, performed in infants and adults for treatment of hydrocephalus from various cause and of various type, failures of this kind manifested themselves usually early in the postoperative period either as a reflux of liquid, not attributable to the operative technique, into the subcutaneous pericatheter tract, or as a reappearance of the intracranial hypertension, without faulty functioning of the ventricular drain. The total success rate was 61% (43/70) but the age of the patient made a clear difference. In patients aged less than 5 months, we observed 11 successes in 33 cases (33%), in those aged less than 1 year, 14 successes in 36 (39%); patients with myelomeninogocele, wherein the shunting was usually done during the first month of life, fared badly; the role of age seems herein predominant. In patients aged more than 1 year, 29 successes in 34 cases (85%) were obtained; results were notably good in nearly all hydrocephalus of tumoral origin. We think the possible role of the "tightness" of the hydrocephalus has to be invoked as also the possibility of spontaneous remission. Ventriculoperitoneal shunting, devoid of the serious complications of ventriculocardiac shunting, is a simple and effective procedure in many cases of hydrocephalus. Means for more accurate prediction of the chances of success in the individual case are needed.